Your upper left tooth has now been missing for a year and your dentist tells you he/she has seen no shifting or tooth movement in the last year. The bigger picture here is that tooth movement and shifting can occur quickly, but also very slowly. There is no way to tell if you will or will not have shifting occur. If you are grinding or clenching your teeth, you are definitely more likely to have shifting and tooth movement. You have two options:1. No treatment. No Implant. Shifting may occur and may not occur. You can also chose to wear an appliance to hold the position and alignment of your teeth to help prevent tooth movement/shifting or take your chances and not wear the appliance.2. Have the Implant placed. Implants have a very high success rate. Be informed that if you do have the implant placed, and you are grinding your teeth, the implant has a higher risk of failure. A tooth and an implant are not the same. Your tooth is held in the bone by ligaments that absorb forces. Under heavy forces, a tooth will flex and crack and you will feel it as pain and soreness to make you aware of the heavy forces you are putting on your teeth. An implant does not have these ligaments. The bone integrates around the implant surface. Implants can only withstand forces down the long axis of the implant. It will not hold up to excursive or lateral forces, like grinding forces. These lateral forces will eventually either fracture the implant, fracture the screw holding the crown, and/or break down the bony interface around the implant causing Peri-Implantitis, which is an infection around an implant. As I stated, Implants do have a very high success rate when the occlusion or bite is correct. If your bite is not in the correct position and you are grinding, you have the option to have your bite corrected to stop your grinding or wear an appliance to relieve forces on the dental implant. The most important thing is to have a dentist be able to inform you of all treatment options, benefits and risks, so the you will be able to make the most informed decision regarding your dental health.
You have several options when it comes to replacing missing teeth.1. Of course, you always have the option of no treatment. With no treatment, comes consequences. Shifting of the teeth and supra-eruption of the opposing teeth (lower tooth opposing missing space drifting upwards)2. Usually the least expensive option is a removable option like the one you were given. A removable partial denture. This will hold the space between the teeth, but does not address the problems that will occur by not maintaining the tissue/bone support. The function of the bone is to hold the teeth. Without a tooth, the bone will begin to resorb and the tissue with follow. Which will also lead to shifting of adjacent and opposing teeth.3. A fixed partial denture or bridge in which a dentist will need to cut down the teeth adjacent to the missing tooth and utilize these teeth as anchors or abutments which will hold the false tooth in place. The anchor teeth must be strong to have a good long term prognosis. It is best if the anchor teeth have not had Root canal therapy, as this will weaken the long term integrity of the tooth due to higher risk of fractures. There are many cons to this treatment option. First, cutting down teeth which most likely do not need treatment, thus destroying healthy tooth structure. Second, splinting teeth together is not a good option because you can't clean thoroughly with flossing and also because if one of the anchor teeth gets a cavity, the entire bridge will need to be replaced. The more times you replace dental work, the less amount of tooth structure remains and the more likely you are to lose teeth. Most importantly, if the occlusion (your bite) is not balanced or is constantly shifting due to grinding/clenching, the bridge will sustain uneven, excessive forces, imagine a see-saw, which will lead to fractures and failure.4. Dental Implants, which are the gold standard treatment for replacement of missing teeth. Dental Implants allow you to only need to replace what is missing without affecting surrounding healthy tooth structure.My advice is to make sure you have all of your options presented to you so that you can make an informed decision.
Sensitivity is a normal side effect of teeth whitening. Whitening products like carbamide peroxide or hydrogen peroxide work by penetrating the enamel surface to get to the discolored molecules. Your teeth are likely to be sensitive while using any whitening products and for a time after you have stopped whitening. To minimize sensitivity while whitening, I recommend brushing at least an hour prior to whitening and waiting at least 2 hours after whitening. Avoid acidic foods and drinks. Use a toothpaste for sensitive teeth or get a prescription strength topical Fluoride, i.e.- Clinpro. If you are experiencing painful sensitivity, I would recommend taking an anti-inflammatory, i.e. Advil. If the sensitivity persists or lingers beyond a couple weeks after stopping whitening, see your dentist. If you have areas of active decay, the whitening products may cause increased sensitivity. Also, if you notice that your gum tissue is red or irritated from the whitening, you may apply a thin layer of petroleum jelly to your tissue prior to whitening.
Yes, grinding or clenching your teeth can cause tooth movement. Your teeth usually contact or touch during functional movements such as swallowing, speaking and eating. If your teeth are touching constantly during the daytime or night time, the excessive force causes swelling to occur in the ligaments that hold the teeth in the bone. This swelling causes the teeth to feel loose and leads to eventual tooth movement, damage to the supporting tissues and destruction of the supporting bone.
